The Annals of Thoracic Surgery, Vol 28, 133-138, Copyright © 1979 by The Society of Thoracic Surgeons
Esophageal carcinoma: an aggressive approach
MH Drucker, KA Mansour, CR Hatcher Jr and PN Symbas
During a 3-year period, 45 patients with esophageal carcinoma (18 of the
lower and 27 of the middle third) underwent esophagectomy and
esophagogastrostomy. All patients were considered to be in Stage I and
Stage II preoperatively, but at the time of operation, 66% were found to
have Stage III disease. All patients underwent mobilization of the stomach
through a laparotomy, and resection of the esophagus and reconstruction of
the continuity of the gastrointestinal tract through a separate right
lateral thoracotomy incision. Following operation, 22 patients (10, Stage I
and II and 12, Stage III) received no radiotherapy and 23 patients (5,
Stage I and II and 18, Stage III) received radiotherapy. Two patients died
in the immediate postoperative period, for a surgical mortality of 4.8%.
Because of the acceptable survival and enhancement of quality of life,
esophagectomy and esophagogastrostomy should be offered not only to Stage I
and II patients with esophageal carcinoma but also to selected patients
with Stage III disease and those with lower and middle third esophageal
lesions.
